REEJA ROBERT PUTHENVEETIL Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****27

License Status

ACTIVE

Business

First Name

REEJA

Middle

ROBERT

Last Name

PUTHENVEETIL

Business Name

REEJA ROBERT PUTHENVEETIL

Original Issue Date

03/12/2024

Effective Date

03/12/2024

Expiration Date

05/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026